Vaccines Beyond 2012

Each year, approximately 1.7 million children die from a vaccine-preventable disease, and the vast majority of these deaths occur in developing countries. This BIO 2012 session, moderated by Peg Willingham of the United Nations Foundation, addressed various ways industry can help increase access to life-saving vaccines for children and adults in resource-poor countries. The thoughts of a few of the speakers on the panel for this session are summarized below.

The panelists suggested that for industry, emerging markets represent a public health challenge but also a growth platform. Marc LaForce of the Serum Institute of India outlined four approaches to this challenge, including a “pull” strategy involving market incentives and a “push” strategy supporting public/private partnerships aimed specifically at developing needed products. LaForce successfully executed a “push” strategy in sub-Saharan Africa. From 2001 to 2012, he led the development, licensure, and introduction of MenAfriVac, the first vaccine designed specifically for Africa where there have been devastating epidemics of meningitis.

Allan Jarvis of Sanofi Pasteur indicated that “partnerships are a means to provide access” to vaccines in emerging markets. Sanofi Pasteur is the largest corporate donor to the Global Polio Eradication Initiative (GPEI), which has helped save an estimated 5 million people from paralysis. The company has also entered into partnerships with local biotechs and research centers in India and Brazil with the goal of delivering affordable vaccines tailored to regional needs. Sanofi Pasteur has expanded its pipeline to include vaccines for diseases that are endemic in the developing world, such as dengue and tuberculosis. Dengue is the most widespread disease in Latin America and Asia Pacific and there are 50-100 million cases globally per year according to estimates from the World Health Organization. Tuberculosis remains a leading cause of death worldwide. These new vaccines will address a significant unmet need.

Jacques Cholat, Vice President of Global Marketing and International Commercial Operations at Merck Vaccines, explained that his company has also established several “local partnerships for local access.” He discussed these partnerships in addition to some of the company’s practices for promoting the distribution and uptake of vaccines, which can depend in part on a country’s gross domestic product (GDP) because GDP is a primary indicator of the health of a country’s economy. Their practices and policies help increase access to vaccines for low-income countries as well as middle-income countries that are too wealthy to be GAVI-eligible but too poor to afford the products the same as developed countries.

One practice is a relatively complex approach that is undertaken by each company independently. It is sometimes called “tiered” pricing, and the tiered structure is often dependent on a country’s GDP. It is one example, among many strategies, used to help deliver affordable vaccines to populations who greatly need them.

While various approaches were discussed during the session, panelists acknowledged that no one approach is best and a multi-faceted strategy may be needed. Jarvis noted that vaccines are complex products and he has yet to see a cookie-cutter solution to any problems in the vaccine business. Flexibility is critical, according to LaForce, and donor interest should dictate the approach, especially with regard to “push”/“pull” strategies.